Fetal Blood Transfusion

Definition

This procedure is done when a fetus suffers from severe
anemia
. Anemia is
a lack of red blood cells. A transfusion means giving the fetus red blood cells from a donor.

There are two types of fetal blood transfusions:

Intravascular transfusion (IVT)—done through the mother’s abdomen into the fetus’s umbilical cord

Intraperitoneal transfusion (IPT)—done through the mother’s abdomen and uterus into the fetus’s abdomen; usually only done if IVT is impossible to do because of the position of the fetus and the umbilical cord

Reasons for Procedure

A transfusion is needed when the fetus's blood count falls too low. Severe anemia in a fetus can cause death. Anemia can be caused by:

Rh incompatibility
—the mother and fetus have a different type of blood, and mother’s antibodies to fetal blood cells destroy fetal blood cells

Twin-to-twin transfusion syndrome—can occur in twin pregnancies where development is in one chorionic sac

The goals of fetal blood transfusions are
to:

Prevent or treat fetal hydrops before delivery—Hydrops is caused by severe anemia in the fetus, which develops into heart failure. This leads to fluid collecting in the skin, lungs, abdomen, or around the heart.

Continue the pregnancy so the fetus can be born close to term

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems like:

If the fetus has hydrops, the blood transfusion will be done right away.

Before the transfusion, you may be given:

Pain medication

Medication to help you relax

Anesthesia

Local anesthesia numbs a small area of your abdomen.

Description of the Procedure

With IVT, the fetus will be paralyzed for a short time. This is to allow access to fetal blood vessels and to reduce injury to the fetus. During both IVT and IPT, the doctor will monitor the fetus with an ultrasound scan. The ultrasound will:

Show the position of the fetus

Guide the placement of the needle through the amniotic sac and into the vessel in the umbilical cord

Record the fetal heart rate

The doctor will insert a needle into your abdomen. Using ultrasound, the doctor will make sure the needle is placed correctly. The needle will go through your abdomen and be inserted into the umbilical cord (IUT) or into the fetal abdomen (IPT). Blood will be transfused to the fetus.

Before the needle is removed, the doctor will take a final blood sample. This is to determine the fetus's blood level. The doctor will find out whether the transfusion was enough and when the next one should be.

The transfusions may need to be repeated every 2-4 weeks until your doctor decides that it is safe to deliver the fetus.

How Long Will It Take?

A 10 ml IVT transfusion will take 1-2 minutes. Usually, between 30-200 ml is transfused during a single procedure.

How Much Will It Hurt?

You will feel pain and cramping where the doctor inserts the needle. If you are close to delivering the fetus or if the procedure is long, the uterus can be sore.

Average Hospital Stay

This procedure is done in a hospital setting. You will be able to go home after the transfusion. If complications occur, you may need to have a cesarean section.

Post-procedure Care

The doctor may give you:

Antibiotics to prevent infection

Medication to prevent contractions or labor

Be sure to follow your doctor’s instructions.

After your baby has been delivered, the baby will need to have follow-up blood tests. The doctor will closely monitor the baby for:

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.